Hand-Specific External Fixation for Treatment of Complex Proximal Interphalangeal Joint Injuries.

Autor: Madi NS; Department of Orthopaedic Surgery, Rutgers University, Newark, New Jersey, United States., Townsend CB; Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States., McEntee R; Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States., Marcus A; Orthopedic Associates of Central Jersey, Edison, New Jersey, United States., Tan V; Institute for Hand and Arm Surgery, Harrison, New Jersey, United States., Beredjiklian P; Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania, United States.
Jazyk: angličtina
Zdroj: Journal of hand and microsurgery [J Hand Microsurg] 2024 Apr 16; Vol. 16 (1), pp. 100005. Date of Electronic Publication: 2024 Apr 16 (Print Publication: 2024).
DOI: 10.1055/s-0042-1751275
Abstrakt: Background: Complex proximal interphalangeal joint (PIPJ) fractures are challenging injuries to treat. There are multiple established treatment methods available for these injuries, including dynamic external fixation. This study reports the outcomes of complex PIPJ fractures treated with a hand-specific external fixation device.
Methods: Twenty-five fingers in 25 patients were treated with the DigiFix external fixator device for treatment of a PIPJ dorsal fracture dislocation ( n = 16) or pilon fracture ( n = 9). There were 16 males and 9 females with a mean age of 40 years (range: 14-75 years) at the time of injury. The median time from injury to surgery was 10 days (interquartile range [IQR]: 5; range: 3-49). Chart and radiographic data were reviewed retrospectively.
Results: The average duration of external fixation was 41 days (range: 26-62 days). At a mean follow-up of 28 weeks (range: 12-105 weeks), the mean PIPJ flexion was 82 (range: 30-105 degrees), extension was -10° (range: -30 to 0 degrees), and flexion/extension arc of motion was 72 degrees (range: 30-95 degrees). Final mean Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 21.5 (range: 0-65.8). There were zero major complications and six (24%) minor complications, including superficial cellulitis (4) and stiffness (2).
Conclusion: Dynamic external fixation for the treatment of complex PIPJ injuries allows for early range of motion and leads to favorable outcomes. This hand-specific external fixator has a reproducible technique which results in predictable and reliable PIPJ distraction.
(© 2024 Published by Elsevier B.V. on behalf of Society for Indian Hand Surgery and Micro Surgeons.)
Databáze: MEDLINE
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